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目的探讨第四脑室内表皮样囊肿的临床表现特点及MRI诊断与鉴别诊断价值。方法回顾性分析经手术病理证实的9例(男5例,女4例)第四脑室内表皮样囊肿患者的临床及影像资料,重点分析MRI特点及手术病理特征。结果 9例患者中,7例行磁共振平扫与增强检查,1例患者行磁共振平扫检查,1例患者直接增强扫描。T_1WI上6例呈低信号,3例呈混杂低信号;T_2WI上5例高信号,3例呈高低混杂信号;FLAIR上2例混杂稍高信号,2例低信号,3例等低信号,1例不均匀低信号;DWI上7例呈明显高信号,1例不均匀稍高信号,1例轻度高信号。静脉注入Gd-DTPA后,7例无强化,1例边缘见线状高信号。结论第四脑室内表皮样囊肿以先天性多见。MRI影像表现具有特征性,对病变诊断及鉴别诊断有重要价值。
Objective To investigate the clinical features and diagnostic and differential diagnosis of the fourth ventricular epidermoid cyst. Methods The clinical and imaging data of 9 cases (5 males and 4 females) of fourth epidermoid cyst proved by surgery and pathology were retrospectively analyzed. The features of MRI and the pathological features were analyzed emphatically. Results Of the 9 patients, 7 patients underwent magnetic resonance plain scan and enhanced MRI. One patient underwent magnetic resonance plain scan and one patient underwent direct contrast enhanced scan. T_1WI in 6 cases showed low signal, 3 cases were mixed low signal; T_2WI on 5 cases of high signal, 3 cases of high and low mixed signal; FLAIR 2 cases of mixed slightly higher signal, 2 cases of low signal, 3 cases of low signal, 1 Cases of uneven low signal; 7 cases of DWI was significantly higher signal, 1 case of slightly higher signal uneven, 1 case of mild high signal. After intravenous injection of Gd-DTPA, there was no enhancement in 7 cases, and a linear high signal was observed in 1 case. Conclusion The fourth intracerebral epidermoid cyst is more common with congenital. MRI imaging has the characteristics of the diagnosis and differential diagnosis of lesions of great value.